Provider Demographics
NPI:1386396422
Name:KRISHNA RAO MD PLLC
Entity type:Organization
Organization Name:KRISHNA RAO MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-844-3567
Mailing Address - Street 1:1615 PRECINCT LINE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3345
Mailing Address - Country:US
Mailing Address - Phone:817-716-0134
Mailing Address - Fax:817-281-3107
Practice Address - Street 1:1305 AIRPORT FWY STE 424
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6608
Practice Address - Country:US
Practice Address - Phone:817-510-1060
Practice Address - Fax:817-510-9940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty